Monitoring vital signs is essential in acute care hospitals. The five vital signs are traditionally blood pressure (BP), pulse, respiratory rate, oxygen saturation (SpO2), and temperature [2]. These indicators are widely used to track the progress of patients. Changing trends in patients' vital signs data can indicate clinical deterioration, which can lead to adverse consequences or death if not identified and treated.
Bringing Continuous Vital Signs Monitoring To General Wards
Patient vital signs monitoring is likely the most common patient care intervention in acute hospitals. Despite this, there has been little research into the efficiency of vital sign monitoring and the ideal frequency of measures, especially given that many potentially avoidable deaths and significant adverse events continue to occur in acute hospitals.
Today's hospitalized patients are getting older, and more senior people are being admitted with numerous chronic illnesses and are at a higher risk of death.
Plus, it is widely known that ICU patients who are at high risk of deterioration require constant monitoring. However, with varying levels of disease and risk of deterioration, there is a growing recognition that monitoring and response in general wards should be addressed similarly to ICUs in consideration of the patient population. [2]
Continuous Vital Signs Monitoring Improves Rapid Response Time
Traditional intermittent manual vital sign monitoring uses early warning score systems, which form a structured approach to critical illness assessment and response, which is similar to triage. Early warning scores have a high predictive value but are restricted by their infrequency. Vital signs are obtained at preset intervals (usually every four hours), with the possibility of the patient worsening between recordings.
One common issue with the traditional intermittent manual vital sign monitoring is that early warning score systems have gaps between observations. So a strategy called Rapid response systems (RRS) is adopted in hospitals to minimize adverse patient outcomes such as cardiac arrest and sudden fatalities in general ward patients. But these systems heavily depend on the team's response time, which also means that it is critically dependent on the timely recognition of patient deterioration to provide that rapid response intervention. [1]
To be able to provide that continuous monitoring at the bedside is one solution to the problem of insufficient monitoring frequency. Continuous vital signs monitoring was previously restricted to intensive care units (ICUs) due to the high staff-to-patient ratios and cumbersome equipment that anchored the patient to the bed space, limiting patient mobility and recuperation. However, wireless data transmission and minimally intrusive remote monitoring technologies have the potential to bring the benefits of ICU-style continuous vital signs monitoring to general wards. [1]
Testing Continuous Vital Signs Monitoring in General Wards
A systematic review published in the International Journal of Nursing Studies has identified twenty-four studies to synthesize together in terms of the effectiveness of continuous vital signs monitoring on clinical outcomes.
The number of centers reporting effective implementation outside of the critical care environment demonstrates the feasibility of continuous monitoring outside of the critical care setting: 10 centers in seven countries have published clinical trials. The majority of studies found advantages in clinical outcome indicators, particularly critical care utilization and hospital stay length. Smaller observational studies discovered that continuous monitoring provided a more accurate depiction of the patient's physiological condition, but they were unable to demonstrate clinical value. [2]
Many other recent studies join a growing body of evidence on how continuous vital sign monitoring can significantly improve patient health outcomes. To find the full list of studies and papers relating to the Sotera Wireless ViSi Mobile device, you can review them here.
Sources:
- https://pubmed.ncbi.nlm.nih.gov/23760698/
- https://europepmc.org/article/med/27582503
